Primary insular carcinoid of the ovary with carcinoid heart disease: Unfavourable outcome of a case
Primary insular carcinoid of the ovary with carcinoid heart disease: Unfavourable outcome of a case
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DOI：
10.1016/j.ijscr.2011.10.014
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发表时间：
2012-01-01
影响因子：
0.6
通讯作者：
Milani, Rodolfo
中科院分区：
文献类型：
--
作者：
Buda, Alessandro;Giuliani, Daniela;Milani, Rodolfo
简介：原发性卵巢类癌是一种非常罕见的疾病。类癌性心脏病发生在大约三分之一的类癌综合征患者中。心脏受累可能是死亡的原因，在这种syndrome.介绍的情况下：我们提出了不利的结果，一个78岁的女子入院抱怨严重的呼吸困难和周围水肿。由于存在大量心包积液并压迫心腔，因此进行了排空性心包穿刺术。计算机断层扫描显示盆腔实性肿块伴腹水。她接受了完整的手术分期。组织学结果显示为IA期岛叶类癌。三周后，她再次入院，超声心动图显示右三尖瓣受累伴狭窄和重度返流，二尖瓣后叶有2 cm肿块。血培养为金黄色葡萄球菌阳性。患者不适合手术干预，并因败血症和二尖瓣心内膜炎继发并发症死亡。讨论：高水平5-HIAA在类癌心脏综合征的发生发展中具有一定的规律性，可导致右三尖瓣受累。在这种情况下，我们提出的细菌性心内膜炎恶化的心脏功能和临床条件之前，她deads.Conclusion：卵巢原发性类癌是非常罕见的肿瘤，需要适当的术前诊断。即使生存率通常很高，但当存在心脏受累的类癌综合征时，必须高度重视，以预防和限制肿瘤分泌的血管活性胺造成的损害。(C)2011 Surgical Associates Ltd.由Elsevier Ltd.出版。CC BY-NC-ND许可下开放访问。
INTRODUCTION: Primary ovarian carcinoid is a very rare disease. Carcinoid heart disease occurs in about one-third of patients with carcinoid syndrome. Cardiac involvement may be a cause of death in this syndrome.PRESENTATION OF CASE: We presents the unfavourable outcome of a 78-year-old woman admitted to the hospital complaining severe dyspnea and peripheral oedemas. Because of the presence of a large pericardial effusion with compression of cardiac chambers, an evacuative pericardiocentesis was performed. Computed tomography showed a solid pelvic mass with ascites. She underwent a complete surgical staging. Histological findings revealed an insular carcinoid stage IA. Three weeks later she was readmitted to the hospital and echocardiography demonstrated a right tricuspid valvular involvement with stenosis and severe regurgitation with a 2 cm masses in the posterior mitral leaflet. Hemoculture was positive for Staphylococcus aureus. Patient was not suitable for surgical intervention and decease due to sepsis and because secondary complications of the mitral endocarditis.DISCUSSION: High level of 5-HIAA has a rule in the development and progression of the carcinoid heart syndrome and could lead the right tricuspid valvular involvement. In the case we presented the bacterial endocarditis worsened the cardiac functions and the clinical conditions before she deceased.CONCLUSION: Ovarian primary carcinoid tumors are very rare tumors that require appropriate preoperative diagnosis. Even if survival is usually excellent, when carcinoid syndrome with heart involvement is present, a high level of attention is mandatory to prevent and limit damage caused by the vasoactive amine secreted by the tumor. (C) 2011 Surgical Associates Ltd. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.